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Why is taking antibiotics with milk a no-no? Does this apply to all antibiotics, or only certain ones?

— Shirley, Ohio

It’s not just milk — there are many other foods that can interfere with antibiotics, as well as other drugs.

In order for oral antibiotics to be effective, they must be absorbed from the gastrointestinal tract, make their way into the bloodstream, and be delivered to the infected area. Many factors influence the body’s ability to accomplish this feat, including the relative acidity of the stomach, the presence of fat or other nutrients in the stomach, and whether certain elements such as calcium are present. The classic family of antibiotics that cannot be taken with milk are the tetracyclines, because the calcium in the milk binds the antibiotic and prevents gut absorption.

For most antibiotics, food results in either a decrease in absorption or has no effect. However, some antibiotics are actually better absorbed when taken with food, and it is recommended that others be taken while eating, because the food does not have a significant impact on absorption and may decrease any potential stomach upset from the drugs.

It is very important to follow the directions on the prescription bottle, because pharmacists are the experts in these interactions. Not following directions may result in the antibiotic failing to cure the infection.

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